From portal to splanchnic venous thrombosis:What surgeons should bear in mind

作     者：Quirino Lai Gabriele Spoletini Rafael S Pinheiro Fabio Melandro Nicola Guglielmo Jan Lerut 

作者机构：Starzl Unit of Abdominal TransplantationUniversity Hospitals Saint-LucUniversitéCatholique Lou-vainB-1200 BrusselsBelgium Oxford Transplant CentreChurchill HospitalOxford University Hospitals NHS TrustOxford OX3 7LEUnited Kingdom Department of GastroenterologyUniversity of Sao Paulo Medical School05508-070 Sao PauloBrazil Department of General Surgery and Organ TransplantationUniversity SapienzaUmberto I Hospital00186 RomeItaly 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2014年第6卷第8期

页      面：549-558页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Liver transplantation Portal vein thrombosis Splanchnic vein thrombosis Thrombectomy Vascular graft Spleno-renal shunt Cavo-portal hemi-transposition Portal vein arterialization Intestinal transplantation Multi-visceral transplant 

摘      要：The present study aims to review the evolution of surgical management of portal(PVT) and splanch-nic venous thrombosis(SVT) in the context of liver transplantation over the last 5 decades. PVT is more commonly managed by endovenous thrombectomy, while SVT requires more complex technical expedients. Several surgical techniques have been proposed, such as extensive eversion thrombectomy, anastomosis to collateral veins, reno-portal anastomosis, cavo-portal hemi-transposition, portal arterialization and combined liver-intestinal transplantation. In order to achieve satisfactory outcomes, careful planning of the surgical strategy is mandatory. The excellent results that are ob-tained nowadays confirm that, even extended, splanch-nic thrombosis is no longer an absolute contraindication for liver transplantation. Patients with advanced portal thrombosis may preferentially be referred to specialized centres, in which complex vascular approaches and even multivisceral transplantation are performed.